Rich pickings

Imagine you had the task of producing an advertising campaign to persuade 18 to 24-year-olds to stop doing something they really love to do: binge drinking. You've tested countless routes, which tell them just how bad it is for their health, but with little or no impact. In fact, your research reveals they're not worried about their health at all at that age, no matter how you present your case. They consider themselves almost invincible (remember those days?)

But then, in the course of your research, you have that Eureka moment. You discover an insight that makes these young people totally reconsider their behaviour; that vanity is much more motivating for them than health issues.

This knowledge enabled our sister consumer agency, VCCP, to develop a TV campaign that showed a young man and young woman, each fully sober, acting like they might do at the end of a boozy evening and posed the question, "You wouldn't start a night like this, so why end it that way?"

Quantitative evidenceNot only did this campaign get an impressive response, but there is now quantitative evidence that it is changing the target group's attitudes to drinking. Exactly the same approach can be applied to developing communications for pharmaceutical companies and rich insights from patients can be just as meaningful or valuable. The question then becomes how do you uncover these insights? What methods, tools and processes do you use that have not been used before?

Market research has a vast array of techniques at its disposal, ranging from focus groups to online forums or semiotics. When an understanding is needed around actual behaviour, such as "what is the physical impact of a condition?" or "how do you measure the impact on quality of life?" it could be worthwhile to pack a bag and a video camera and go to live with patients and their families.

First-hand observation of patients across the many different contexts and social settings they encounter has been found to be a valuable research method. Pharmaceutical companies are now hiring the skills of a new breed of researcher. These are the ethnographic researchers, who immerse themselves in the day-to-day lives of patients with a video camera, notebook and a sharp eye for uncovering those valuable insights.

Up closeEthnography has its roots in the academic discipline of anthropology. While traditional anthropologists might live alongside people from a distant country for years at a time, the commercial ethnographer is more likely to spend three or four days with patients and their families, living anywhere from a teeming metropolis to a nondescript town in the middle of England. This still allows time to develop rapport and trust, which are key to making sense of the difference between reported behaviour (what people say) and actual behaviour (what people do). Ethnography has the ability to dig deep and reveal the differences between these two perspectives in order to identify such things as: • The physical and psychological impact on individuals' and carers' lives • How patients really manage their condition• Gaps in the marketplace based on latent needs.

Often, people, whether we are referring to them as patients or consumers, are not aware of their behaviour, nor can they articulate their own needs. This presents real challenges to marketing and brand teams whose job it is to craft effective communications and messaging that will connect with those patients and their prescribers.

Through the patients' eyesIt is not simply a matter of passively observing the patient during the research; ethnographers treat the people involved as the experts. Listening and being empathetic sustains the observations.

The film-making style is unobtrusive. Often, at the end of the filming, patients watch the unedited footage with the ethnographer and add comments about what they were doing and why. This can also be used as a voice-over in the final edited version presented to the client. This helps us see events through the patients' eyes and often helps reframe the questions being investigated.

The challenge ethnographers face is in maintaining a balance between the two positions of viewing and recording events as an objective outsider and maintaining intimacy and reciprocal involvement as a guest or adopted member of a group.

ShockThe films presented back to clients often shock and surprise. On one recent study in the US investigating early-stage Alzheimer's disease, an ethnographer was filming a man driving a car, who appeared lucid and socially functioning.

Suddenly, he forgot how to get to his local grocery store. He pulled over to the side of the road and was clearly starting to feel panicked and disturbed. He asked himself how he could drive something as complex as a car but, in an instant, forget where he was in his own neighbourhood.

This example provided a compelling and powerful real-life story that challenged the communication team's preconceptions about how early-stage dementia affects people. It really helped shape the creative agency's understanding of what it must be like for patients. It also provided evidence of the overwhelming sense of anxiety Alzheimer's causes to family and carers, something that was overlooked in previous studies.

Holding onIn March 2008, the Vesicare Europe team at Astellas commissioned an ethnographic research study to gain a close understanding of how overactive bladder (OAB) affects people's lives. This research demonstrated how such urgency was a significant inconvenience, which left the majority with hard choices about their future.

Some participants talked openly of their experiences for the first time. They described how, for example, OAB was such a significant part of their lives and how they felt isolated because they had to plan around where the nearest toilet facilities were. They talked about the fear of taking on a permanent job because of the stigma of being 'found out' and ridiculed, as well as the feeling of shame and anxiety when having to leave the room at a moment's notice during company meetings. One person was an aerobics instructor who had had OAB for six years, but never knew treatment existed.

During research, we saw a woman sprinting down London's Oxford Street, desperate to find a toilet in an area she didn't know. She would only ever wear black, even in summer, as she was afraid of leaking in public. Almost all of the participants had urgent episodes just as they got to their front door, as turning the keys provoked a sudden potential emergency.

These examples of real people's experiences inspired Astellas to share this insight with healthcare professionals. The films were shown at medical congresses, including the International Urogynaecological Association (IUGA) conference, with experts from over 20 European countries attending, including surgeons, consultants and physicians.

Adding valueBefore you embark on a new campaign, it's worth considering how well you really know your patient. Are there insights, of which you may be unaware currently, that could help shape your whole communications strategy? You may have a lot of rational data, but are there emotional connections that could help you develop a programme with much more impact?

Not only will such insights help make your communications to patients far more relevant and empathetic, they can also make any activity aimed at healthcare professionals more engaging. They become more valuable to physicians because they get a much better understanding of their patients' experiences than they generally would gain from a seven-minute consultation.

Using this type of research helps a pharmaceutical company to demonstrate well-rounded expertise in a therapy area, going beyond the science.

Potentially, it can also help differentiate one brand from another, when both have similar or equal efficacy, or enable a brand to keep its edge even if a competitor brings out new data.

Close working with creative and research agencies can make best use of these insights to develop a strategy that informs everything you do, including digital activity, salesforce materials, meetings with key opinion leaders, conference material, exhibitions and PR. The task then is to get everyone involved aligned and fully aware of the benefits.